Key Takeaway
Court ruling on no-fault and uninsured motorist subrogation requiring physical examination and prima facie proof of serious injury and medical necessity.
This article is part of our ongoing prima facie case coverage, with 73 published articles analyzing prima facie case issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
Allstate Ins. Co. v Cajo, 2012 NY Slip Op 50292(U)(Civ. Ct. Queens Co. 2012)
“Plaintiff’s right to commence this action did not accrue until September 9, 2011 and post-dated the filing of a notice of trial by the plaintiff.However, the defendants did not move to dismiss the action as untimely. Instead, the defendants have moved to strike the action from the calendar pending completion of discovery, specifically, a physical examination of plaintiff’s subrogor, Milagros Lopez. Although the plaintiff’s right to commence this action has now accrued, it would be unjust to permit the plaintiff to benefit from the premature commencement of the action. Therefore, the notice of trial will be vacated and the action stricken from the trial calendar.
The defendants dispute the cause and extent of the physical injuries for which the no fault benefits and uninsured benefits, sought to be recovered in this action, were paid to plaintiff’s subrogor and have served a demand for a physical examination of Milagros Lopez. The benefits paid to plaintiff’s subrogor were substantial and at her deposition she testified that she still has some pain from her injuries. Therefore, the plaintiff is required to produce Milagros Lopez for a physical examination by the physician designated by the defendants (see CPLR §3121; NYCCA § 208.13).”
So, the Plaintiff subrogee needs to prove that the subrogor (1) sustained a serious physical injury (UM benefit recovery); and (2) the medical services were medically necessary, in order to obtain a recovery in this case.
Surprisingly, there is not a lot of case on the issue involving no-fault and UM (SUM) subrogation.
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Legal Update (February 2026): Since this 2012 decision, there may have been amendments to CPLR §3121 regarding physical examination procedures and requirements, as well as potential updates to NYCCA § 208.13 governing no-fault subrogation actions. Additionally, case law developments over the past 14 years may have refined the standards for physical examinations in subrogation cases and the procedural requirements for proving serious injury thresholds. Practitioners should verify current statutory provisions and recent appellate decisions when handling similar subrogation matters.
Legal Context
Why This Matters for Your Case
New York law is among the most complex and nuanced in the country, with distinct procedural rules, substantive doctrines, and court systems that differ significantly from other jurisdictions. The Civil Practice Law and Rules (CPLR) governs every stage of civil litigation, from service of process through trial and appeal. The Appellate Division, Appellate Term, and Court of Appeals create a rich and ever-evolving body of case law that practitioners must follow.
Attorney Jason Tenenbaum has practiced across these areas for over 24 years, writing more than 1,000 appellate briefs and publishing over 2,353 legal articles that attorneys and clients rely on for guidance. The analysis in this article reflects real courtroom experience — from motion practice in Civil Court and Supreme Court to oral arguments before the Appellate Division — and a deep understanding of how New York courts actually apply the law in practice.
About This Topic
Prima Facie Case Requirements in New York
Establishing a prima facie case is the threshold burden that every plaintiff or moving party must meet. In no-fault practice, the standards for a prima facie case on summary judgment have been refined through extensive appellate litigation — covering the sufficiency of claim forms, proof of mailing, medical evidence, and the procedural prerequisites for establishing entitlement to benefits. These articles analyze what constitutes a prima facie showing across different claim types and the evidence required to meet or defeat that burden.
73 published articles in Prima Facie case
Keep Reading
More Prima Facie case Analysis
CPLR 3212(g) struck
New York appeals court clarifies burden of proof standards in no-fault insurance cases, addressing when plaintiffs must prove compliance with verification requests at trial.
Mar 29, 2018Prima facie case for trial purposes
Analysis of two NY appellate cases establishing prima facie requirements for no-fault insurance trials, including burden of proof for claim submission and payment denial.
Jan 8, 2018A tongue twister from the Fourth Department
Fourth Department appellate court ruling on res judicata, law of the case doctrine, and prima facie requirements in no-fault insurance mailing disputes.
May 4, 2010The errant notice to admit
Court rules improper notice to admit cannot establish prima facie case for no-fault insurance EUO nonappearance, highlighting discovery limits in litigation.
Oct 6, 2015Amended motion/Admissible Reply papers/Defects in affidavits/delay letter vs. verification requests
Court ruling on amended motions, defective IME affidavits, and delay letters vs. verification requests in New York no-fault insurance litigation procedures.
Aug 6, 2013Another prima facie disaster in the second department
Second Department court ruling in Flatlands Med. v Allstate shows strict prima facie requirements for no-fault insurance summary judgment motions under CPLR 3212(g).
Apr 8, 2012Common Questions
Frequently Asked Questions
What does 'prima facie case' mean in no-fault litigation?
In no-fault litigation, the provider or claimant bears the initial burden of establishing a prima facie case by submitting proof of the claim — including evidence that the services were provided, the claim was timely submitted, and the amount billed is correct. Once the prima facie case is established, the burden shifts to the insurer to demonstrate a valid defense, such as medical necessity denial, lack of coverage, or failure to appear for an EUO or IME.
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About the Author
Jason Tenenbaum, Esq.
Jason Tenenbaum is the founding attorney of the Law Office of Jason Tenenbaum, P.C., headquartered at 326 Walt Whitman Road, Suite C, Huntington Station, New York 11746. With over 24 years of experience since founding the firm in 2002, Jason has written more than 1,000 appeals, handled over 100,000 no-fault insurance cases, and recovered over $100 million for clients across Long Island, Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, the Bronx, and Staten Island. He is one of the few attorneys in the state who both writes his own appellate briefs and tries his own cases.
Jason is admitted to practice in New York, New Jersey, Florida, Texas, Georgia, and Michigan state courts, as well as multiple federal courts. His 2,353+ published legal articles analyzing New York case law, procedural developments, and litigation strategy make him one of the most prolific legal commentators in the state. He earned his Juris Doctor from Syracuse University College of Law.
Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
If you need legal help with a prima facie case matter, contact our office at (516) 750-0595 for a free consultation. We serve clients throughout Long Island (Huntington, Babylon, Islip, Brookhaven, Smithtown, Riverhead, Southampton, East Hampton), Nassau County (Hempstead, Garden City, Mineola, Great Neck, Manhasset, Freeport, Long Beach, Rockville Centre, Valley Stream, Westbury, Hicksville, Massapequa), Suffolk County (Hauppauge, Deer Park, Bay Shore, Central Islip, Patchogue, Brentwood), Queens, Brooklyn, Manhattan, the Bronx, Staten Island, and Westchester County. Prior results do not guarantee a similar outcome.